scholarly journals Inositol Treatment and ART Outcomes in Women with PCOS

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Deepika Garg ◽  
Reshef Tal
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Function ◽  
Current Knowledge ◽  
Polycystic Ovary ◽  
Mature Oocyte ◽  
Reproductive Age ◽  
Vitro Fertilization ◽  
Ovulatory Dysfunction ◽  
Ovarian Morphology

Polycystic ovary syndrome (PCOS) affects 5–10% of women in reproductive age and is characterized by oligo/amenorrhea, androgen excess, insulin resistance, and typical polycystic ovarian morphology. It is the most common cause of infertility secondary to ovulatory dysfunction. The underlying etiology is still unknown but is believed to be multifactorial. Insulin-sensitizing compounds such as inositol, a B-complex vitamin, and its stereoisomers (myo-inositol and D-chiro-inositol) have been studied as an effective treatment of PCOS. Administration of inositol in PCOS has been shown to improve not only the metabolic and hormonal parameters but also ovarian function and the response to assisted-reproductive technology (ART). Accumulating evidence suggests that it is also capable of improving folliculogenesis and embryo quality and increasing the mature oocyte yield following ovarian stimulation for ART in women with PCOS. In the current review, we collate the evidence and summarize our current knowledge on ovarian stimulation and ART outcomes following inositol treatment in women with PCOS undergoing in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI).

scholarly journals Contemporary approaches to the management of polycystic ovary syndrome

2018 ◽  
Vol 9 (4) ◽  
pp. 123-134 ◽  
Author(s):  
Renato Pasquali
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Ovarian Function ◽  
Polycystic Ovary ◽  
Review Article ◽  
Metabolic Abnormalities ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Ovulatory Dysfunction ◽  
Ovarian Morphology

Polycystic ovary syndrome (PCOS) is a common disorder in women in their reproductive years and is characterized by androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. It is also associated with several metabolic abnormalities, particularly insulin resistance and obesity, which play an important role in the pathophysiology of PCOS and, in particular, negatively influence ovarian function and fertility. This review article summarizes the available treatment for women with PCOS. Specifically, current and potentially new therapies are discussed.

scholarly journals The Place of In Vitro Maturation in Assisted Reproductive Technology

2019 ◽  
Vol 01 (01) ◽  
pp. 11-15 ◽  
Author(s):  
Lan N. Vuong ◽  
Tuong M. Ho ◽  
Robert B. Gilchrist ◽  
Johan Smitz
Keyword(s):  
Assisted Reproductive Technology ◽  
Ovarian Stimulation ◽  
In Vitro Maturation ◽  
Polycystic Ovary ◽  
Reproductive Technology ◽  
Vitro Fertilization ◽  
Medication Costs ◽  
Main Barrier ◽  
Patient Burden

In vitro maturation (IVM) is an assisted reproductive technology (ART) whereby immature cumulus-oocyte complexes are collected and matured in vitro, without need for controlled ovarian stimulation and ovulation triggering. Advantages of IVM over in vitro fertilization (IVF) include mild or no stimulation, lower medication costs and less patient burden. However, early clinical outcomes with IVM were suboptimal. More recently, clinical studies reported live birth rates after IVM of about 40%. New IVM culture systems are being used to improve the efficacy of IVM. These have been in widespread use for animals for many years and are now showing promise in the clinical setting. Patients more likely to benefit from IVM over IVF include those at risk of OHSS (e.g. women with polycystic ovary syndrome), when the time for ovarian stimulation is limited, or where sustained elevations of estradiol are contraindicated (e.g. oncofertility indications). The main barrier to use of IVM to date was its relative efficacy compared with IVF, and there have also been concerns over the health of infants born following IVM. However, no differences in congenital abnormalities between IVM and other ARTs have been identified. In addition, there is a lack of both experience and standardized protocols. Strategies to overcome barriers to the use of IVM include better training for clinicians, more and better funded research in the field, and improved recognition of IVM by fertility specialists. Overall, IVM offers a valuable alternative for ART in select patient populations. New approaches to IVM appear to have the potential to achieve pregnancy outcomes equivalent to those after IVF. Increasing the use of IVM in the future can be achieved with improved training and education for fertility specialists, and increased funding for IVM research, with the ultimate goal of improving fertility outcomes.

The Parkes lecture: controlled ovarian stimulation in women

Reproduction ◽  
2000 ◽  
pp. 201-210 ◽  
Author(s):  
SG Hillier
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Function ◽  
Recombinant Dna ◽  
New Drugs ◽  
Controlled Ovarian Stimulation ◽  
Recombinant Dna Technology ◽  
Vitro Fertilization ◽  
Ovarian Folliculogenesis

Recent advances in knowledge of the endocrine and paracrine mechanisms that regulate human ovarian folliculogenesis have been parallelled by the introduction into clinical practice of new drugs that can be used safely and effectively to stimulate ovarian function in infertile women. Most notably, recombinant DNA technology has been applied to the production of molecularly pure forms of the gonadotrophins, FSH and LH, opening the way to the development of improved strategies for manipulating the ovarian paracrine system. The clinical objectives of controlled ovarian stimulation fall into two categories, depending on patient needs: (1) induction of multiple follicles from which mature oocytes can be harvested for use in assisted reproduction protocols such as in vitro fertilization and embryo transfer; or (2) induction of spontaneous ovulation of a single mature follicle so that conception might occur in vivo. This review summarizes the physiological principles upon which the use of gonadotrophins for clinical purposes is based, highlighting new opportunities for improved treatment as a result of the availability of recombinant FSH and LH.

Options for generating polycystic ovary syndrome based on experimental findings in animal models

2020 ◽  
Vol 69 (4) ◽  
pp. 89-100
Author(s):  
Maria I. Yarmolinskaya ◽  
Elena I. Abashova ◽  
Olga L. Bulgakova
Keyword(s):  
Animal Models ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Indirect Methods ◽  
Ovulatory Dysfunction ◽  
Ovarian Morphology ◽  
Genetic Interventions ◽  
Experimental Findings

Polycystic ovary syndrome (PCOS) is a common endocrine pathology that affects 814% of women of reproductive age. The leading signs of the disease are hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Over the past decades, a variety of animal models have been developed to study the etiology and pathogenesis of PCOS, including chemical, hormonal, and genetic interventions. However, a large number of experimental techniques differ even in the framework of a single model. In this review article, we summarized PCOS animal models using both direct hormonal effects and indirect methods.

scholarly journals PCOS and Assisted Reproduction Technique: Role and Relevance of Inositols

Endocrines ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 515-522
Author(s):  
Paolo Giovanni Artini ◽  
Elisa Malacarne ◽  
Vito Cela
Keyword(s):  
Ovarian Function ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Assisted Reproduction Technique ◽  
Positive Role ◽  
Vitro Fertilization ◽  
Beneficial Effects ◽  
Insulin Sensitizers

Polycystic ovary syndrome is an endocrine disorder often characterized by insulin resistance and hyperinsulinemia, especially in overweight/obese women. Among insulin sensitizers, the positive role of inositols has been increasingly established in recent years. The action of inositols not only concerns the metabolic parameters of these patients, but also the hormonal profile, resulting in beneficial effects on ovarian function. For this reason, many studies have tried to recognize their role in PCOS infertile women who underwent in vitro fertilization (IVF) procedures.

scholarly journals The Impact of Endometriosis on Controlled Ovarian Stimulation Outcome

2021 ◽  
Author(s):  
Dragoș Albu ◽  
Alice Albu
Keyword(s):  
In Vitro Fertilization ◽  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Predictive Value ◽  
Reproductive Age ◽  
Important Predictor ◽  
Controlled Ovarian Stimulation ◽  
Vitro Fertilization ◽  
The Impact

Endometriosis, a frequent condition in reproductive age women, is also associated with infertility by mechanisms incompletely clarified. The effectiveness of endometriosis treatment for infertility is debated, being possible that in vitro fertilization (IVF) offers a better alternative. The response to controlled ovarian stimulation (COS) is an important predictor of live birth, but it might be affected in endometriosis possibly through a decrease of ovarian reserve. Moreover, the predictive value of anti-mullerian hormone (AMH) for the response to COS could be altered by factors disrupting the AMH production in endometriosis. Therefore, we aim to review the literature regarding the response to COS and the AMH production and their predictive value for COS response in patients with endometriosis.

scholarly journals Serum Concentrations of Oocyte-Secreted Factors BMP15 and GDF9 During IVF and in Women With Reproductive Pathologies

Endocrinology ◽  
2019 ◽  
Vol 160 (10) ◽  
pp. 2298-2313 ◽  
Author(s):  
Angelique H Riepsamen ◽  
Karen Chan ◽  
Shelly Lien ◽  
Prudence Sweeten ◽  
Mark W Donoghoe ◽  
...  
Keyword(s):  
Polycystic Ovary ◽  
Reproductive Age ◽  
Poor Responders ◽  
Serum Concentrations ◽  
Serum Samples ◽  
Vitro Fertilization ◽  
Oocyte Number ◽  
Secreted Factors ◽  
Diagnostic Potential

Abstract Oocyte-secreted factors bone morphogenetic protein 15 (BMP15) and growth differentiation factor 9 (GDF9) are critical for folliculogenesis and fertility. This study developed ELISAs for the measurement of BMP15 and GDF9 in serum and investigated their usefulness as biomarkers of female reproductive function. Serum samples were obtained from women undergoing infertility treatments (n = 154) and from perimenopausal and postmenopausal women (n = 28). Serum concentrations of BMP15 and GDF9 were analyzed in women relative to age, anti-Müllerian hormone, number of oocytes retrieved, and polycystic ovary syndrome (PCOS) after superovulation for in vitro fertilization. BMP15 and GDF9 immunoassays were validated for specificity, sensitivity (24 and 26 pg/mL, respectively), and reproducibility. BMP15 and GDF9 were detectable in 61% and 29% of women, respectively. BMP15 and GDF9 varied 64-fold and 15-fold, respectively, between women, but they did not change within subjects following ovarian stimulation with gonadotropins. Serum GDF9 concentration, but not BMP15 concentration, was associated with oocyte number retrieved in patients without PCOS (P = 0.018). GDF9 and BMP15 associations with oocyte number differed significantly (P < 0.05) with PCOS status. GDF9 concentrations were lower in poor responders (women with fewer than four oocytes retrieved or with cancelled cycles; P = 0.020). Serum BMP15, but not GDF9, was lower in women >55 years of age, compared with women of reproductive age (P < 0.01). This study develops and validates immunoassays to quantitate BMP15 and GDF9 in human serum and to correlate concentrations with female reproductive potential. Although assay sensitivities require improvement, this study demonstrates the diagnostic potential of oocyte-secreted BMP15 and GDF9 as serum biomarkers in reproductive medicine.

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